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    Title: Renal protective efect of sacubitril/valsartan in patients with heart failure
    Authors: Hsieh, Hui Ling;Chen, Chun You;Chen, Cheng Hsien;Hsu, Shih Chang;Huang, Wen Cheng;Sue, Yuh Mou;Lin, Feng Yen;Shih, Chun Ming;Chang, Yue Cune;Huang, Po Hsun;Liu, Chung Te
    Date: 2021-02-25
    Issue Date: 2021-03-04 12:12:05 (UTC+8)
    Abstract: Sacubitril/valsartan is a combined neprilysin inhibitor/angiotensin II receptor blocker designed for
    treatment of heart failure (HF). Nonetheless, its renal protective effect remained an issue of debate.
    This retrospective cohort study investigated the renal protective effect of sacubitril/valsartan in HF
    patients. HF patients on sacubitril/valsartan or valsartan for > 30 days were matched for gender, age,
    estimated glomerular filtration rate (eGFR), and left ventricular ejection fraction (LVEF) to be enrolled
    into analysis. The follow-up period was 18 months. The outcomes included end eGFR, renal function
    decline defined as 20% reduction of eGFR, mortality, and HF-related hospitalization. Each group had
    137 patients after matching. The mean age was 72.7 years and 65.7% were male. Mean eGFR was
    70.9 mL/min/1.73 m2 and LVEF was 54.0% at baseline. Overall, the eGFR of sacubitril/valsartan groups
    was significantly higher than valsartan group at the end (P < 0.01). Subgroup analysis showed that
    the difference in eGFR was significant in subgroups with LVEF ≥ 40% or eGFR ≥ 60 mL/min/1.73 m2.
    Multivariate Cox regression model showed that sacubitril/valsartan group had significantly reduced
    risk for renal function decline (hazard ratio: 0.5, 95% confidence interval: 0.3–0.9). Kaplan–Meier
    curve showed no difference in the risk for cardiovascular mortality, all-cause mortality or HF-related
    hospitalization. We showed renal protective effect of neprilysin inhibition in HF patients and specified
    that subgroups with LVEF ≥ 40% or eGFR ≥ 60 mL/min/1.73 m2 were sensitive to this effect, suggesting
    an optimal subgroup of this treatment.
    Relation: Scientific Reports 11(1), 4593
    DOI: 10.1038/s41598-021-84118-8
    Appears in Collections:[Graduate Institute & Department of Mathematics] Journal Article

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